LEUKEMIA 259 



These crystals were first observed by Robin 1 (1853) in leukemic tissues, 

 but have been named after Charcot, who, with Robin, described their 

 properties. They were described by Charcot as colorless, refractile, 

 elongated octahedra ; insoluble in alcohol, ether, and glycerin ; soluble 

 in hot water, acids, and alkalies ; size variable, from 0.016 by 0.005mm. 

 up. These crystals have been found not only in the tissues and blood 

 of cadavers, but also occasionally in the freshly drawn blood of 

 leukemics. Poehl 2 believes them to be the same as Bottcher's spermin 

 crystals, and derived from decomposed nucleins. Schreiner considers 

 that these spermin crystals are phosphoric acid salts of spermin 

 (CJLN), or, as Majert and Schmidt give it, C,H 10 N 2 , with the structure 



CH-CH 

 HN<^ /NH, thus being similar to, although not identical 



X CH 2 CH/ 



with, piperazin. The entire question of the composition of spermin is 

 still unsettled, 3 however ; and it is probable, furthermore, that the crystals 

 found in leukemia are not identical with the crystals observed in semen. 

 Crystals that appear similar are also found in asthmatic sputum, 

 empyema, and ascites fluid, bone-marrow, and tumors, and it has been 

 suggested that they are derived from or related to the oxyphile granules 

 of theeosinophiles.* This view implies an agreement with Gumprecht's 

 opinion that the crystals seen in bone-marrow, asthmatic sputum, etc., are 

 not spermin, but of proteid nature. As can be seen, the nature and signifi- 

 cance of Charcot' s crystals are, at the present time, quite undetermined. 



Summary. The chemical changes observed in leukemia 

 depend upon the excessive quantity of leucocytes and lymphoid 

 tissue, which undergo processes of disintegration at irregular 

 intervals, with the result that the products of nucleoproteid 

 destruction (uric acid, purin bases, and phosphoric acid) appear 

 in the urine in increased quantities. As the large neutrophiles 

 contain abundant autolytic enzymes, the products of cell autol- 

 ysis (proteoses, amino-acids, and products of nucleoproteid 

 destruction) may appear at times in the urine and in the blood ; 

 because of the small amount of such enzymes in the lympho- 

 cytes, these changes are all much less marked in lymphatic 

 leukemia. Charcot' s crystals, which are perhaps derived from 

 leucocytic nucleoproteids, may be found in the blood and tissues, 

 The changes in the red cells are chiefly those of a secondary 

 anemia, with occasionally some chlorotic features. The chem- 

 ical findings of leukemia throw no light whatever upon the cause 

 of the disease. 



Hodgkin's disease (pseudo-leukemia) shows only the evidences 



1 Earlier literature given by Ewing, " Clinical Path, of Blood," 1901, p. 

 218 ; and by v. Limbeck, " Clinical Path, des Blutes," 1896, p. 318. 



2 Deut. med. Woch., 1895 (21), 475. 



3 Literature, see Hammarsten, Amer. Transl., 1904, p. 420. 



4 Literature, see Floderer, Wien. klin. Woch., 1903 (16), 276 ; Predtets- 

 chensky, Zeit. klin. Med., 1906 (59), 29. 



